Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.

A survey released by the Centers for Disease Control and Prevention found that 33 percent of U.S. workers with arthritis suffered work limitations in 2003, the latest data available.

In Kentucky, slightly more than half of arthritis sufferers reported work limitations. Nevada had the lowest percentage, with about a fourth of its adults saying their work was limited.

“What was surprising about this was just how high and how strong an impact arthritis does have on work,” said Kristina Theis of the CDC. The study is the first to provide a state-by-state breakdown on the impact of arthritis in the workplace.

An all-ages problem“It’s not just an aging problem, but it’s a problem that hits people of all ages and adults. It changes people’s lives dramatically and for decades,” said Dr. Steven Abramson, director of rheumatology of New York University Hospital for Joint Diseases, who was not involved in the study.

Arthritis comprises more than 100 different conditions, affecting an estimated 46 million Americans. The most common forms are osteoarthritis — affecting mostly older people — gout and rheumatoid arthritis. Symptoms generally include pain, aching, stiffness and swelling in or around the joints.

Overall, nearly 7 percent of all working adults in U.S. states experienced arthritis-related workplace limitations. Kentucky had the highest percentage of workers, 15 percent, with such limitations, and Hawaii had the lowest, with about 3 percent, the CDC study said.

The study relied on a random sample telephone survey in which health officials asked workers whether they had ever been told by a doctor they had arthritis or a related condition. Then they were asked whether arthritis or joint symptoms affected their ability to work and the type of work they could do.

Erica Gerber, 37, of Richmond, Va., said she was on her honeymoon in 2002 when her first symptoms of rheumatoid arthritis struck — swollen joints. Six months later, the condition forced her to end her job as a property manager.

“I was in the prime of my career. I became completely disabled. It just wrecked everything,” she said. “The simplest things — from buttoning a shirt to getting down the steps of my townhouse just became impossible.”

The CDC recommends people with arthritis exercise and take part in self-management programs such as one sponsored by the Arthritis Foundation that has been found to significantly decrease pain, Theis said.

“What we want to do is treat arthritis as early and as effectively as possible so we can keep people at work,” said Dr. W. Hayes Wilson, national medical adviser for the Atlanta-based Arthritis Foundation.

A CDC study released in January said that the nation’s cost for arthritis and related conditions was $128 billion in 2003, including roughly $81 billion in direct costs such as medical expenses and $47 billion in indirect costs, such as lost wages.